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"Does ERAS benefit higher BMI patients? A single institutional review"
Hope D Shin1, Abigail M Rodriguez1, Jasson T Abraham1
1Division of Plastic Surgery, Department of Surgery, Baylor Scott & White Medical Center-Temple, 2401 S. 31st Street MS-01-E443, Temple, TX 76508, United States.
Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|September 25, 2020
Summary
Enhanced recovery after surgery (ERAS) protocols shorten hospital stays for patients undergoing free flap breast reconstruction, particularly benefiting those with higher BMIs. This approach optimizes care without increasing complication risks.
Area of Science:
- Plastic Surgery
- Surgical Oncology
- Patient Recovery Protocols
Background:
- Enhanced Recovery After Surgery (ERAS) protocols are gaining traction in plastic surgery to improve patient outcomes.
- Obesity presents increased risks for postoperative complications, necessitating optimized care strategies.
- Free flap breast reconstruction is a complex procedure where patient optimization is crucial.
Purpose of the Study:
- To assess the impact of ERAS protocols on length of stay (LOS) and complication rates in free flap breast reconstruction patients.
- To stratify the effects of ERAS based on Body Mass Index (BMI).
Main Methods:
- Retrospective review of 123 patients undergoing abdominally based free flap breast reconstruction (2014-2017).
- Data collected included ERAS protocol participation, demographics, LOS, complications (minor/major), and 30-day reoperation rates.
- Patients were stratified by BMI to analyze ERAS impact across different obesity classes.
Main Results:
- ERAS patients experienced a significantly shorter LOS (4.14 days) compared to non-ERAS patients (4.69 days).
- Patients with higher BMIs showed progressive LOS reductions with ERAS: Class I obese (0.99 days decrease) and Class II+ obese (1.35 days decrease).
- No significant differences in minor complications, major complications, or reoperation rates were observed between ERAS and non-ERAS groups.
Conclusions:
- ERAS protocols safely reduce LOS in free flap breast reconstruction, with greater benefits observed in patients with higher BMIs.
- ERAS implementation enhances patient recovery without elevating the risk of postoperative complications compared to traditional care pathways.
Keywords:
Autologous breast reconstructionBreast reconstructionDiepERASFree flapLength of stayMicrosurgerymstramMore Related Videos
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